Dietary Goals on Jan 14, 1977, Goals for the United the Senate Select Committee on Nutrition and Human Needs' may be a turning point in the role of government in determining nutrition priorities for the American people. Before commenting on these goals and their political source, I would like to review the events that led to this controversial announcement and the events that led to its subsequent modification. Since 1968, Sen George McGovern (Democrat, SD) and his committee have been concerned with bridging the gap between the food and farm interests in the Agriculture Committee and the health, welfare, and research interests in the Labor and Public Welfare Committee. They were provided with oversight responsibilities in nutrition and initiated legislation concerned with preventing hunger. Among the accomplishments of the committee had been expansion of the food stamp program, the school lunch program, the summer food program, and the school breakfast program. The "WIC" (Women, Infants, and Children) program was established through the work of this committee as was nutrition research as a separate mission in the Depart¬ ment of Agriculture and the creation of a system of comprehensive nutri¬ tion education programs for school¬ children. By 1975, the interests of the committee turned toward considering

The byDietary

announcement

of States

for the United States the role of overnutrition as a possible cause of some of the ten "killer diseases," primarily coronary heart disease, obesity, cancer, and stroke. Hearings were held and 13 panels of experts were convened. The conclu¬ sion was reached that overnutrition, specifically, too much saturated fat, refined sugar, and cholesterol, did play an important role in causing these diseases and that consumers should have this information and alter their eating habits. The specific suggestions have since been modified and will be detailed here. The commit¬ tee said that the US government should have a nutrition policy and that legislation that affected agriculture, the food industry, and related health matters should implement this poli¬ cy.

The original dietary goals drew considerable reaction from many quarters. Physicians and nutritionists disagreed with the dietary goals and with each other and wrote editorial comments both pro and con.2-' The producers of meat and eggs asked for further hearings before actions were taken that would reduce the sales of their products. The committee re¬ ceived many letters from individuals and professional associations. The requested hearings took place and were published in toto. The supple¬ mentary views were carefully col¬ lected and published in a volume of 869 pages.' All opinions expressed were patiently heard. By December

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1977, a second edition of Dietary Goals published. "' The first step had

was

matured considerably but was still a gawky adolescent, but absolute dieta¬

ry recommendations had turned to ranges, and pregnant women and infants were excluded from the rec¬

ommendations. Alcohol as a source of calories was dealt with specifically. It is apparent from the introduction of the report that many members of the committee became much more sophis¬ ticated in the evaluation and interpre¬ tation of data and opinions than they had been only a year before. The modified dietary goals are as follows: 1. To avoid being overweight, con¬ only as much energy (calories) as is expended; if overweight, decrease energy intake and increase energy sume

expenditure. the

consumption of complex carbohydrates and "naturally occurring" sugars from about 28% of 2. Increase

energy intake to about 48% of energy

intake. 3. Reduce the consumption of re¬ fined and other processed sugars by about 45% to account for about 10% of total energy intake. 4. Reduce overall fat consumption from approximately 40% to about 30% of energy intake. 5. Reduce saturated fat consump¬ tion to account for about 10% of total energy intake, and balance that with polyunsaturated and monounsatu-

rated fats, which should account for about 10% of energy intake each. 6. Reduce cholesterol consumption to about 300 mg/day. 7. Limit the intake of sodium by reducing the intake of salt (sodium chloride) to about 5 g/day. The final recommendations to courage achievement of these

goals

are as

follows:

en¬

dietary

1. Congress should provide money for a public education program based these or similar goals. This on program should reach schoolchildren, school food service workers, recipients of federally funded food assistance programs, and participants in pro¬ grams of the Extension Service and the US Department, of Agriculture. There should be extensive use of tele¬ vision to educate the public. 2. Congress should require food labeling for all foods. 3. Congress should provide money to the US Department of Agriculture and the Department of Health, Educa¬ tion, and Welfare to conduct jointly studies and pilot programs in food processing to reduce risk factors in the diet. 4. Congress should increase fund¬ ing for human nutrition in the De¬ partment of Agriculture and establish a committee for coordination of nutri¬ tion research undertaken by both the Department of Agriculture and the Department of Health, Education, and Welfare. 5. These two departments should

form a joint committee to periodically consider the implications of nutrition¬ al health concerns on agriculture poli¬ cy.

There are two aspects of the dietary goals that need comment, namely, the process by which the goals were devel¬ oped and the specific goals them¬ selves. Conclusions reached by a com¬

mittee of the US Senate are reached by a political process that involves input from many components of our society, including consumers, scien¬ tists, and representatives of agricul¬ ture, industry, and -medicine. Al¬ though experts on the subject matter involved are included, and although their testimony may have more weight than that of others, it is the responsibility of elected officials to weigh the testimony that they hear. It is also a public process. Those most influenced by the results of the delib¬ erations have an opportunity for input. The Senate Select Committee on Nutrition and Human Needs con¬ cluded that a national nutrition policy was needed and that its implementa¬ tion should occur through actions of the government. The development of nutritional goals, like other aspects of public policy, is inherently a political rather than a scientific process. Although it is subject to inputs from persons of varying degrees of exper¬ tise and although it is not devoid of prejudice, it is a sound process as long as it includes opportunity for revision and recognition of different view¬ points. The present goals must be

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considered to be only an early phase of this process that needs further refine¬ ment. The recommendations that ac¬ company them deserve detailed con¬ sideration. Federal funding of nutri¬ tion education for the public, the label¬ ing of all foods with nutrient composi¬ tion, support of further studies on risk factors in the diet, coordination of nutrition research within the govern¬ ment, and periodic consideration of nutritional health implications of agricultural policy are all important steps that should be taken. It is the responsibility of the professionals with an interest in nutrition, includ¬ ing pediatricians, to participate in this process as individuals and through the organizations to which they belong. The nutrition community has the responsibility to take a leading role. CALVIN W. WOODRUFF, MD Department of Child Health School of Medicine University of Missouri Medical Center Columbia, MO 65212 References 1. Select Committee

on

Nutrition and Human

Needs, US Senate: Dietary Goals for the United States. February, 1977. 2. Harper AE: Dietary goals\p=m-\askeptical view. Am J Clin Nutr 31:310-321, 1978. 3. Hegsted DM: Dietary goals\p=m-\aprogressive view. Am J Clin Nutr 31:1504-1509, 1978. 4. Select Committee

on

Nutrition and Human

Needs, US Senate: Dietary Goals for the United States\p=m-\SupplementalViews. November, 1977. 5. Select Committee

on

Nutrition and Human

Needs, US Senate: Dietary Goals for the United States, ed 2. December, 1977.

Dietary goals for the United States.

Dietary Goals on Jan 14, 1977, Goals for the United the Senate Select Committee on Nutrition and Human Needs' may be a turning point in the role of go...
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